Infants Born to Mothers with Diabetes in Pregnancy at the Population Level in Manitoba: More Questions than Answers

Abstract

ObjectiveReport some novel associations seen between maternal diabetes in pregnancy (DIP) and infant morbidity over the first year of life. MethodsA retrospective population based cohort of infants born at 34 to 41 weeks of gestational age (GA) was assembled; using individual and area-level income for socio-economic status (SES). Neonatal morbidity was measured as diagnoses received during the birth stay. First year outcomes were neonatal readmissions (up to 28 days) and postneonatal admissions (29 to 365 days). Logistic regression controlled for confounders. ResultsThere were 25 312 infants: 6.1% preterm, 32.4% low SES, and 4.8% had mothers with DIP. During the newborn period maternal DIP increased the odds of nonrespiratory morbidity (odds ratio [OR] 8.1; 95% confidence interval [CI] 6.9–9.5), need for phototherapy (OR 2.3; 95% CI 1.8–2.9) and neonatal intensive care unit admission (OR 2.8; 95% CI 2.4–3.4) and had an unclear relationship with respiratory outcomes. Maternal DIP did not demonstrate a significant association with neonatal admissions. Maternal DIP increased the odds of postneonatal admissions (OR 1.2; 95% CI 1.0–1.5) but not in the respiratory subgroup (OR 1.0; 95% CI 0.7–1.3). ConclusionsMaternal DIP is a significant risk factor for infant morbidity that persists over the first year of life. Its consistent lack of an association with respiratory morbidity in this cohort suggests an interaction with SES and merits further investigation.